Developing Communication Skills with GP Trainees: The REAM Approach

Dr Rachel Elliott, Dr Samantha Scallan

Background
Communication skills development is one of the cornerstones of training for general practice. The subtleties of communication in the consultation can be an area with which trainees struggle. Increasing emphasis on the assessment of the consulting skills of trainees using simulation and role-play throughout training, has seen GP educators seeking to develop activities to focus on consulting skills early in training. 

Summary of Work
The aim of this work was to design a teaching activity around communication skills which would raise the awareness of trainees to their approach to consulting in order to help them tune into the areas they needed to develop.  GP trainees (ST1-3, n 76) attended a simulated consultation circuit comprising cases written by RE. Although reflecting clinical cases and played out as such in role play, the scenarios were non-medical in their subject matter. This was intended to help the trainees focus on the process rather than the content of the ‘cases.’ Trainees were scored using the RCGP marking scheme and they received written feedback on their performance.

Summary of Results
Trainees in ST1/2 valued the opportunity to role play the problem solving element of the consultation and demonstrated use of a consultation model to structure their approach.   ST3 trainees felt that the lack of clinical content made the cases less valuable for their stage of learning.

Conclusions
The REAM approach to role playing case scenarios offers educators a diagnostic tool to explore consultation skills with trainees in the early years, a means to explore process over content. It is, however, less relevant and valuable to trainees in their final year.